Alzheimer’s Disease

This is the most common cause of dementia and accounts for about 7 in 10 of all dementias.

It typically begins with memory problems and slowly gets worse over time. People will often notice that

they can't remember things that happened recently, even though they can still remember what happened years ago.

They will often find that they have difficulty recalling particular words and naming objects. Sometimes they are not aware of their memory loss and the problem is noticed by others.

They may also find it hard to:

Learn new things.

Remember recent events, appointments or phone messages.

Remember the names of people or places. This can lead to problems with even simple daily activities.

Understand or communicate with others.

Remember where they have put things. They may worry that someone has been in their house or has taken things.

Understand that there is anything wrong with them. They may become cross when someone tries to help them.

Carers often comment that people with Alzheimer’s show subtle changes to their personality. For example, they might behave or react differently to how they did before they became ill.

In Alzheimer's, damaged tissue seems to build up in the brain to form deposits called 'plaques' and 'tangles'.

These cause the brain cells around them to die. The disease also affects the chemicals in the brain which transmit messages from one cell to another. The chemical most affected is acetylcholine.

Vascular dementia

This is usually caused by the blood vessels supplying the brain becoming damaged or blocked.

This can lead to small strokes, or parts of the brain dying, as they are starved of oxygen and nutrients.

This dementia can come on more quickly than Alzheimer’s. Someone with vascular dementia is more likely to suffer from conditions which lead to blocked arteries, such as high blood pressure, smoking, diabetes or high cholesterol.

It is difficult to predict how vascular dementia will progress. There may be no further problems for months or years, but then more strokes, or other illnesses, can lead to further deterioration.

The problems caused by vascular dementia depend on which part of the brain is affected.

There may be memory loss and difficulty concentrating.

Language difficulties are common - as they are in Alzheimer’s.

It is common to suffer from mood swings or to feel depressed.

Some people have episodes of confusion and may be aggressive or distressed.

Others may experience hallucinations (where they see something that is not there).

Sometimes there are physical problems, for example difficulties with walking or incontinence.

It is possible for people to have a combination of vascular and Alzheimer’s dementia. It can be very

hard, even for doctors, to tell the difference between them. A brain scan can sometimes help.

Lewy body dementia

This seems to be caused by protein deposits (Lewy bodies) building up in the brain.

This can lead to symptoms which overlap with Alzheimer’s disease and Parkinson’s disease. These include:

Memory problems and difficulty planning tasks.

Confusion which can vary during the course of the day.

Vivid visual hallucinations of people or animals.

Trembling of hands, muscle stiffness, falls or difficulty with walking.

Fronto-temporal dementia

This dementia seems to affect the front of the brain more than other areas. It often starts in people in their 50s and 60s.

Because it affects the front of the brain, it is more likely to cause personality and behavioural changes.

So a person who is usually very polite and proper might start to become irritable or rude. Memory can remain good for a long time.

Rarer causes

There are many different causes for dementia and these account for less than 5% of cases. Some of these are listed below:

This will depend on the diagnosis and your circumstances. Unfortunately, there are no cures for these conditions.

It is important to help someone with dementia stay as independent and as mobile as possible, for as long as possible.

A psychological treatment called group cognitive stimulation has been shown to help with memory and improve the quality of a person's life.

Reminiscence Therapy involves the discussion of past activities, events and experiences with another person or group of people. This has been shown to have beneficial effects on both understanding and knowledge (cognition), and in reducing the strain on carers.

A group of drugs called Acetylcholinesterase Inhibitors and another drug called Memantine that can treat some of the symptoms of Alzheimer's dementia, and help people to maintain their independence for longer.

Lifestyle

Eat a healthy diet (supplements such as Vitamin E and Ginkgo Biloba are not currently recommended).

Planning

There may come a time when it is difficult to make decisions about important matters in your life, such as managing finances or medical decisions.

You can give a trusted relative, friend or solicitor the right to make such decisions on your behalf if you cannot. This is called a Lasting Power of Attorney (LPA). A solicitor can help you arrange an LPA.

There are 2 types of LPA - one for the management of ‘Property and Financial Affairs’, and another for matters involving ‘Health and Welfare’.

Property and financial affairs LPA - Attorneys can be appointed to make decisions about such things as banking and investments, property sales, tax and benefits.

Health and welfare LPAs - Attorneys can be appointed to make decisions about such things as medical treatment, day-to-day care and place of residence.

All LPAs must be registered with the Office of the Public Guardian before they can be used.

Note re: Enduring Power of Attorney (EPA): the LPA has now replaced the EPA. However, valid EPAs that were executed before 1 October 2007 will continue to be valid, even if they have not yet been registered.

Advance Decisions - it is possible to make known decisions to refuse certain medical treatments in the future should you lose the capacity to make decisions.

These will be respected by the professionals providing care. This can be made at the same time or separately from a LPA.

This is me

For people with memory problems, it is important that professionals can easily see important information about them.

‘This is Me’ is a document that can be completed for this purpose. It has lots of useful information about people's medical history, their life and preferences.

It can travel with them to appointments or hospital admissions and is available here; This is Me

Depression and anxiety

People with dementia commonly become depressed and anxious. But, it is also possible for depression to look like a dementia. Like dementia it will affect a person's ability to look after themselves.

This is called ‘pseudo-dementia' and it is important to identify it and treat it. If you are concerned that you or a relative may be depressed, seek advice from your GP in the first instance. Depression can be treated with antidepressants and talking therapy.

Getting help and support

If you are worried about your memory, make an appointment to see your GP. They may do some simple tests to check your memory, and perhaps organise some blood tests.

If needed, your doctor can refer you to a specialist team, a psychologist or a specialist doctor. These people can carry out more detailed tests and arrange a brain scan if needed.

Some areas have memory clinics where these assessments are carried out. Also see below for other organisations that can provide information and support.

If you need help with practical activities and day-to-day care or benefits, you can contact your local authority for advice about social care and carer support services.

If you know or care for someone who is having difficulties making decisions about their personal health, finance or welfare, you may need to apply to the Court of Protection so that you (or someone else) can make decisions for them.